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Oral & Maxillofacial Surgery Associates of Western Michigan Plc

Oral & Maxillofacial Surgery (D.M.D.) in Grand Rapids, MI · enumerated 2006 · authorized official J Domin, Member.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1598772626

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Registry record

Entity type Organization (Type 2)
Legal business name Oral & Maxillofacial Surgery Associates of Western Michigan Plc
Practice address 2140 Lake Michigan Dr Nw, Grand Rapids, MI, 49504
Phone (616) 791-9600
Fax (616) 791-9603
Enumeration date Aug 2, 2006
Last updated in NPPES Apr 12, 2010

Taxonomy & classification

204E00000X Oral & Maxillofacial Surgery (D.M.D.) Allopathic & Osteopathic Physicians Primary

Authorized official

Name J Domin
Title Member
Phone (616) 791-9600

Other identifiers

Identifier Type State Issuer
970D111530 Other - BCBSM BCN/CHOICE
CC0861 Other - MEDICARE RAILROAD
0N13750 Other MI MEDICARE GROUP NUMBER

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Oral & Maxillofacial Surgery Associates of Western Michigan Plc located?
The practice location on file with NPPES is in Grand Rapids, MI.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2010-04-12. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2010-04-12.